federal healthcare law

On Tuesday, two federal appeals courts issued conflicting decisions that could have major ramifications for the future of the Affordable Care Act.

The controversy hinges on whether people in the 36 states that opted NOT to set up their own health insurance exchanges can qualify for subsidies (really, tax credits) on their health insurance premiums. Missouri and Illinois are among those 36 that don't have state-run exchanges.

Starting on October 1, Missourians will be able to shop for health insurance through a new online marketplace. It’s one of the biggest changes in health insurance coverage under the federal Affordable Care Act.

But there’s still a lot of confusion about how the exchanges will work.

St. Louis Public Radio's Véronique LaCapra spoke with the Missouri Foundation for Health’s Ryan Barker to try to get some answers. Here's an excerpt from their conversation.

A Missouri Senate interim committee looking into the state's Medicaid system heard from several doctors and other health care providers Wednesday at a hearing in Jefferson City.

Among those testifying was Thomas Hale, M.D., a St. Louis-based physician working with Sisters of Mercy. He told the panel that Medicaid needs to be expanded to make up for the pending loss of federal reimbursements to hospitals, known as DSH payments ("dish").

A federal court is scheduled today, to take up one Missouri businessesman’s challenge to a recently enacted provision of the federal health law. The provision requires that most employee-health plans include no-cost coverage of contraceptives. But the rule has faced backlash from several businesses and lawmakers around the region.

A federal judge in St. Louis has dismissed a lawsuit challenging the contraception mandate of the federal health care law.

The lawsuit filed on behalf of Frank O'Brien and his company, O'Brien Industrial Holdings LLC of St. Louis, was one of nearly three dozen cases nationally challenging the constitutionality of regulations in the health care law. Among other things, O'Brien, a devout Catholic, claimed the requirement to pay for birth control infringes on his religious beliefs.

Few issues have generated as much passion and attention recently as health care. Like many Democrats and Republicans around the nation, Missouri's U.S. Senate candidates are on opposites sides of the issue.

Democratic Sen. Claire McCaskill supports and defends the health care law signed in 2010 by President Barack Obama. Her Republican challenger, congressman Todd Akin, wants to repeal it.

The language used in a ballot initiative approved by Missouri Secretary of State Robin Carnahan has been tossed out by a Cole County judge.

Proposition-E centers on the conditions for creating a health care exchange in Missouri. It read in part if the law should, quote, “deny individuals, families and small businesses the ability to access affordable health care.” Republican Lt. Governor Peter Kinder called the language used by the Democratic Secretary of State unbelievably biased.

The idea of a health care exchange in Missouri continues to be a political sticking point between Republicans and Democrats. And Missouri Governor Jay Nixon has yet to take a stance on the issue.

The day after Republican Lt. Governor Peter Kinder filed a lawsuit that alleges the wording for a healthcare exchange ballot initiative is misleading; Governor Jay Nixon did his best to sidestep the issue.

In fact, Nixon says he hasn’t really looked at how the ballot measure is written. As for the idea of healthcare exchanges in general, the governor isn’t ready to commit.

In the wake of the Supreme Court’s ruling upholding the federal health law, Missouri Governor Jay Nixon is not taking a clear stance on whether he thinks the state should take part in a voluntary expansion of its Medicaid program. The health law originally required states to raise Medicaid eligibility to about 130 percent of the federal poverty level. But the Supreme Court ruling now leaves that decision up to states. Speaking to reporters in Kansas City Monday, Nixon said he hopes to work with providers, businesses, and lawmakers to figure out what’s best for Missouri.

A new report by the Missouri Foundation for Health estimates that about two-thirds of Missouri’s more than 800,000 uninsured could get health insurance under the federal health care law. The county level data suggest that rural counties will benefit the most.

Some of Missouri's largest insurance companies will be refunding consumers almost $61 million this month under a provision of the federal healthcare law. Insurers who failed to spend at least 80 percent of premium-dollars on medical care and quality improvement have to repay the difference to consumers.

Top Missouri Republicans say they have no intention of expanding Medicaid eligibility as a result of the Supreme Court's ruling on the federal health care law.

The high court struck down a provision Thursday that threatened states with the loss of existing federal Medicaid dollars if they refuse to expand coverage to adults earning up to 133 percent of the federal poverty level. That ruling essentially makes the expansion optional for states.

House Majority Leader Tim Jones says the Republican-led Legislature will not consider the expansion.